When Gov. Jay Inslee announced in April that the state was training more than 1,000 people to do case- and contact-tracing investigations, it was hailed as a key component to slowing the spread of the new coronavirus.
Now, nearly five months since that plan was revealed, a report released Wednesday by the Washington State Department of Health (DOH) shows the state has yet to meet its goals for the program.
The report, which will be updated weekly, shows DOH case and contact investigators have reached within 24 hours 49% of people who have tested positive for the virus that causes COVID-19. Within 48 hours, they’ve reached 70% of people who have been in close contact with an infected person.
DOH’s goals are to reach 90% of diagnosed people within one day and 80% of contacts within two days.
The report covers case and contact investigation from Aug. 2 to Sept. 5 and doesn’t go further back because DOH had to get a system in place that could track tracing efforts, said the state’s health officer, Dr. Kathy Lofy.
“While we expect our outcomes to improve over time, this initial data shows we have work to do,” Secretary of Health John Wiesman said in a Wednesday news release about the report. “I urge all Washingtonians to please answer or call back right away if you are contacted by public health.”
DOH doesn’t do all case and contact investigations in the state and is working to collect data from local health jurisdictions handling the work.
Contact tracing isn’t new and has been used by public health investigators for many years to combat other infectious diseases. When effective, case and contact tracing can identify a cluster of cases and choke the virus off before it spreads.
The process begins when test samples are sent to laboratories. The samples are supposed to be accompanied by the test subject’s contact information. If a person tests positive, their phone number is passed on to case investigators. An investigator then calls the person to determine who they have been in contact with and then calls the contacts.
It didn’t take long for the system to break down early in the pandemic as SARS-CoV-2 was silently spreading through the Puget Sound region and quickly overwhelmed local public health districts. Public Health – Seattle & King County stopped tracing efforts in March when it couldn’t keep up. The Snohomish Health District and Tacoma-Pierce County Health Department did the same and asked people who tested positive to inform their close contacts.
Public Health – Seattle & King County is now finding more success with its case and contact tracing investigations, compared to the early days of the pandemic. On Wednesday, the public health agency shared its contact tracing data on its COVID-19 dashboard.
There are 61 tracers who are doing about 500 cases a week, which accounts for about 95% of cases reported in King County. During the past four weeks 64% of cases were interviewed the day they were called by a contact tracer.
Inslee announced a contact tracing plan on April 21 that included more than 700 people from the National Guard, about 800 Department of Licensing employees, and about 630 employees of local and state health departments.
Contact tracers have faced persistent problems in reaching people who have tested positive and their contacts because laboratories don’t always include contact information, or because people don’t answer or return calls from tracers.
The five weeks’ worth of data in DOH’s report shows that about 25% of people wouldn’t tell investigators about who they had been in contact with, didn’t call back or refused to participate.
“Many people with COVID-19 who we interviewed are not willing to reveal the names of their close contacts to Public Health,” Lofy said. “During the week of Aug. 30, of the 217 cases investigated only 53 close contacts were identified.”
Washington state isn’t alone in its contact tracing struggles. Arizona, Florida and other states weren’t able to keep pace with the tidal wave of infections this summer. The problems faced in those states were much the same as here: bad contact information and people not wanting to speak with public health investigators.
Contact tracing works best when the people contacted interact with tracers, Lofy said.
“We need folks from the public to either answer their phones or call us back quickly, to participate in interviews and to share information about their contacts,” Lofy said, “so that we can reach out to their contacts and make sure that they’re aware of their potential exposure, so that they don’t expose other people.”